Understanding PTSD (Part Two)

This is a continuation of Understanding PTSD (part one) which was posted to this blog in May this year.

Read "Part-One" here.

Symptoms of PTSD may not be present for a while after the traumatic event or experience.

Forcing a person to talk about a traumatic experience before they are ready in increases the likelihood of that person developing PTSD.

After being raped in 2009, I went to the police; where I had to talk about the experience, in great detail; before I felt ready to talk about what had happened. This was not the first time I had been raped; but this was, however, the first time I've reported an experience like this to the police.

I believe talking, about this particular experience, before I were ready, could have brought the PTSD, (which I believe I did already have, despite not yet receiving a diagnosis of such from a qualified mental health professional) and it's symptoms, to the forefront of my behaviour.

Triggers, or reminders, of the experience, can not only bring back extremely vivid memories of the incident (flashbacks), and bring back feelings related to the trauma. It can also, even, cause physical "re-experiencing" such as an itching, and/or, a throbbing or stabbing pain, in an area of the body for seemingly no reason and possibly not in a place on the body associated with what happened.

With PTSD a person may find themselves avoiding situations and locations which are reminders of the traumatic incident or experience.

Complex PTSD

"Complex PTSD" is a diagnosis which given for a reaction to prolonged and repeated trauma which, generally, involves a person being held in a state of captivity - either physically or emotionally.

In these situations a person is under the control of the perpetrator and is unable to get away from them.

I found myself in this type of situation between 2005 and 2007.

I were in an abusive "relationship" spanning almost two years.

This abuse included:

• Emotional abuse - name calling (directed at myself); being told that I were a "Bad girlfriend"; when I cried, usually after he had hit me, he would accuse me of "Blackmail" and of trying to "Guilt-trip" him; and, him convincing me that I was worthless and that he could do better.
• Sexual abuse - he often had sex with me without my consent, when I was unconscious and/or under the influence; and, sometimes, when I was unconscious, and/or in a "drugged-up" state, he would invite his friends to "Join in."
• Physically - he would lose his temper over all issues with me, no matter how tiny, responding by punching or slapping me.

During this period I remained in denial about what was going on - I would refer to him as "My boyfriend" - but, in reality, I felt trapped by him; I felt scared and unable to escape.

The memories of him make me feel sick, shameful and anxious. Often flashbacks, to my time with him, are followed by a panic attack (sweating, heart palpitations, and shortness of breath).

The symptoms of Complex PTSD are identified as:

• alterations in a person's control on their emotions - which may include, persistent sadness, thoughts of self- harm and suicide, and explosive or inhibited anger;
• alterations in a person's state of consciousness - which can include, forgetting traumatic events; reliving the traumatic experience; and feelings of dissociation (feeling as though one is detached from their body and mental processes);
• changes in self-perception - which may include feelings of helplessness, shame, guilt, and a sense of feeling different from other people;
• alterations in how a person perceives the perpetrator - examples, of which, include attributing power to the perpetrator, becoming preoccupied with the relationship to the perpetrator, or preoccupied with getting revenge on the perpetrator;
• alterations in a person's relations with others - which can include distrust, isolation, or a repeated search for a rescuer;
• changes in a person's system of meanings - which may include a loss of sustaining hope and faith, or a sense of hopelessness and despair.

During the two-year abusive relationship I often experienced "out of body" feelings - where I felt as if I were looking down upon my abuser and myself - I would disassociate myself from the situation so that it often feels as though what happened during that time, happened to somebody else.

Since the abusive relationship, I have developed a distrust of men, particularly  of those who are "romantically" interested in me. 

I have developed a negative perception of myself. Often, during moments of anger, I refer to myself as a, "Whore" - a perception of myself which I project onto others as if it is their opinion of me. 

I used to see my abuser as a "Boyfriend." It has taken me a very long time to come to terms with the experience. I have only, just recently, been able to admit the truth about what happened out loud, despite the relationship ending in 2007.

Stigma towards PTSD*

Stigma towards PTSD often ignores the deep level of impact a traumatic experience has on a person; which can lead to people, who don't understand the complexity of PTSD, to make unhelpful off-hand comments, such as, 

"Get over it."

"Move on."

"Stop living in the past."

PTSD can - and often does(!) - go ignored, due to others' disbelief of the occurrence of a traumatic event, or experience.

Common stigma towards PTSD also includes a "Blaming the victim" mentality. A person who has experience abuse repeatedly is sometimes mistaken as being of a "weak character". Survivors have been unfairly blamed for the symptoms they experience - i.e. survivors may be accused of having a self-image of victimisation. 

They may have, also, been misdiagnosed by mental health professionals as having Borderline, Dependent, or Masochistic Personality Disorder.

PTSD affects survivors for years and often has a deep impact on a person, affecting their self-perception and their relationships with others. But, despite its impact, the symptoms of PTSD may not be apparent to those who are around a survivors of abuse, leading to people underestimating the effect the abuse has had on the person. 

It has been found that PTSD can be overcome; with talking therapies - such as CBT (cognitive behavioural therapy) - being shown to be the most effective treatment.

*After furthering my research on PTSD I found stigma towards PTSD to be more prevalent than I first thought.

Understanding PTSD

The title of this post was going to be ‘Understanding BPD and PTSD’; but, instead, I have decided to go with the more-accurate (in terms of this post’s content) and shorter title of, ‘Understanding PTSD’.

However, as promised, I will still be looking at the “crossover” between PTSD and BPD.

Understanding PTSD (Part-Two)  ~  posted 09/07/2012

The term Post-traumatic stress disorder (PTSD) refers to a range of symptoms which are a response to a traumatic event (or, events) which undermine our sense of safety and security.

(PTSD is also sometimes referred to as PTSS (Post-Traumatic Stress Syndrome.)

Symptoms of PTSD may not appear for some time – weeks, months and, even, years – after the traumatic experiences or event.

and;

Even if you’re not directly involved in a traumatic event, you can still be affected by the event and develop symptoms of PTSD.

It is perfectly natural to be affected by some of these symptoms after a dangerous and/or frightening event. 

Sometimes people are affected by very serious symptoms, which then dissipate within a few weeks – their symptoms could be diagnosed as ASD (Acute Stress Disorder).

When symptoms last for longer than a few weeks, and become an ongoing problem, then they may be the symptoms of PTSD.

and;

It is within the symptoms of PTSD and BPD where the crossover between these two mental health diagnoses’s becomes relevant. 

PTSD causes many symptoms, which can be grouped into three categories; “Re-experiencing symptoms,” “Avoidance symptoms,” and “Hyper-arousal symptoms.”

“Re-experiencing symptoms” includes those symptoms such as, flashbacks - repeatedly reliving the trauma, which can include physical symptoms such as a racing heart or shortness of breath; disturbing dreams; and, upsetting and frightening thoughts.

“Avoidance symptoms,” also known as “Dissociative symptoms,” include symptoms such as, staying away from anything that is a reminder of the traumatic experience; feeling emotionally numb (also known as dissociation); strong feelings of depression, guilt, or anxiety; a loss of interest in activities which were once enjoyable in the past; and, difficulty remembering the traumatic event.

“Hyper-arousal symptoms” includes symptoms such as, being easily startled or “jumpy”; feeling tense or “on edge”; insomnia and/or disturbed sleep pattern; and, angry outbursts.

Those whom have survived a traumatic, and/or near-death, experience tend to prefer to think of themselves as “Survivors” - as opposed to the term “Victim” - due to PTSD being a sign of a mind which has experienced something which has been stretched it beyond the normal human capacity for coping.

Some survivors have objected to the term “disorder” - but the diagnosis recognises the events and experiences, beyond our control, which have a lasting and damaging effect on a person’s mental health.

Initially, trauma tends to cause feelings of “numbness” – a stage which is sometimes referred to as “Being in denial.” 

But, although a person may seem in a state of “denial,” it is likely that on a sub-conscious level they are beginning to process the traumatic experience.

At first, talking about their experiences will most likely be the last thing a person wants to do; and pressuring or forcing a person to talk about their experience before they are ready can be extremely harmful, and increases the likelihood of them developing PTSD.

Different types of traumatic experiences affect people differently; for example, reactions/responses to pro-longed trauma (such as, survivors of repeated abuse), may differ from those whom are survivors of “Single event trauma.”

Responses, or reactions, to trauma differ from person-to-person, and people should be allowed to work through traumas at their own pace.

The symptoms of PTSD are a sign of a person who has seen too much, and whose mind has been stretched beyond the normal capacity for coping.


Understanding PTSD (Part-Two)  ~  posted 09/07/2012

Understanding BPD and Other Personality Disorders (Part Three)

Understanding Borderline Personality Disorder and Other Personality Disorders (Part-Three)

Within this blog post (and throughout this blog-series) I wish to further explore the thought processes, and behaviours, related to BPD (and other personality disorders); and how these relate to our rapidly changing states of mind, feelings and emotions.

(The mental health diagnosis I have been given is that of borderline personality disorder. ~ Nicola Edwards)

                                           

This blog post is a continuation of "Understanding BPD and other personality disorders" Parts One and Two.

One of the recognised symptoms of borderline personality disorder is "identity disturbance" - which is, a significant, and persistently, unstable self-image or sense of self - and is, another large contributing factor towards my own difficulties with communicating and interacting, with other people and the world around me.

"Identity disturbance" is also known as "identity diffusion" (terms which refer to the difficulties a person may have in determining who they are in relation to other people).

Often, I feel as though I am not a real person, I feel as if I am non-existent. 
Like, I'm a work of fiction; an invisible; a ghost.

Identity disturbance can make it hard for people, like myself, to find our place in the world; and difficult for us to identify, or convey, a "consistent" and "stable" personality.

Those with borderline personality disorder often report changing who they are depending on the circumstances and how they believe others want them to behave.
This I can certainly relate to: in most situations I will attempt to "blend in."

Often find I find myself "tailoring" my behavior to suit the circumstances or situation.

I observe the other people around me, and will then imitate them, in order to display behavior which I believe is deemed to be appropriate at that time.

Sometimes, upon observing and imitating others' behavior, their current behavior will seem to contradict past behavior or actions. When this happens, I find myself reassessing the appropriateness of my own behavior and actions.

Although it is true to say that everyone changes their behavior to some extent in different situations, but with BPD this change in behavior tends to be more profound.

Throughout this blog series on BPD, and other personality disorders, I have been referring a lot to the inconsistencies in those of us with borderline personality disorders, in terms of our thoughts, behaviors and actions.

The "definition" of a borderline personality disorder diagnosis is based upon signs of emotional instability, feelings of depression and chronic emptiness.

The inconsistencies and conflicts in thoughts, behaviors and actions - associated with BPD - tend to leave me at odds with myself; often with my own behavior, and actions, working in spite of myself.

For example:

• Within my relationship with my parents.

Despite being in my twenties and living alone in independent accommodation, I'm still very dependent on my parents (I spend a lot of time with them, and they often help me out with day-to-day chores).

However, I also often feel "crowded" by them and feel that they are working against me.

I thoroughly enjoy my independence, but also long to be "looked after", or "cared for" by another person.

• My thoughts and actions work in spite of myself in a similar way in terms of "Isolation vs. Socialising."

I go through periods of self-isolation - in other words cutting myself off from everyone. But, even during these periods of self-isolation, I become depressed due to extreme feelings of loneliness.

• Within my relationship with my friends.

When I meet someone whose company I truly enjoy and feel comfortable with; I form "intense" relationships with that person, which can sometimes make my company feel quite demanding.

I focus on those relationships which I have "favouritised", which can cause myself to become partly-dependent upon that particular friend. This may include behaviors such as calling a friend for support at "unreasonable hours" (ie. late-night/early-morning phone-calls).

• Within "sexual" and/or "romantic" type relationships.

My present feelings and ideas towards all relationships will be rooted in, and based upon, past experiences.

The abusive nature of most of my past "sexual" and "romantic" experiences, means that my present and current ideas towards those types of relationships are very "mixed-up"

I feel confusion and fear towards these sorts of relationships.

Due to past experiences I devalue myself in order to feel approval. I tend to distrust all those whom I "fall" for, I believe that they will use my feelings towards them against me as a form of control and abuse.

....

Understanding the "identity disturbance" in a borderline personality disorder diagnosis can help to understand the inconsistencies and conflicts in our thoughts, feelings, behaviors, and actions.
Understanding "identity disturbance" can help to understand why those of us with the diagnosis behave the way we do.

The next part of this blog series will be titled, "Understanding BPD and PTSD" -where I will look at the crossover between a borderline personality disorder diagnosis and a post-traumatic stress disorder diagnosis.

Related previous blog posts:

'Understanding BPD and other personality disorders (Part One)' ~ April 2012

'Understanding BPD and other personality disorders (Part Two)' ~ April 2012

'What is BPD?' ~ August 2010